NURS 6540- Advanced Practice Care for frail Elders
Exam Study Guide
1
Which assessment tool measures economic resources, mental health, and activities of
0
daily living?
rs
1. Lawton's Physical Self-Maintenance Scale
2. Older Americans Resources and Services Assessment
e
3. Problem Oriented Medical Record
t
4. Short Portable Mental Status Questionnaire
as
All care plans for older adult patients include:
m
1. a bowel and bladder program.
z
2. a fall prevention program.
i
3. discharge planning.
u
4. reminiscence therapy.
q
An older adult patient, who is recovering from surgery, has a sodium level of 128 mEq/L
and is confused. The physician diagnoses syndrome of inappropriate secretion of
antidiuretic hormone. The gerontological nurse's primary goal for this patient is to:
1. decrease edema by restricting free water intake.
2. prevent complications of hyponatremia.
3. reorient the patient to his or her surroundings.
4. restore the patient's fluid and electrolyte balance.
The adult children of an aging couple ask a gerontological nurse about alternative
therapies or nontraditional services to improve their parents' health. The nurse's most
appropriate response is to:
1. discuss the benefits, risks, and limitations of various therapies.
2. distinguish between folk and traditional medicine.
all the be
,3. give a firm warning about alternative therapies.
4. recommend a reputable holistic health therapist.
A 73-year-old patient is admitted to a rehabilitation facility after sustaining a mild stroke.
After three nights in the facility, the patient begins to sleep only four to five hours a night
and to awaken frequently during the night. The patient then complains of not feeling
rested and begins to nap during the day. Which is the most appropriate nursing action?
1. Completing an assessment of the patient's sleep-wake cycle to determine
necessary interventions
2. Doing nothing since this type of sleep pattern is associated with normal aging
1
3. Inquiring if the patient takes a medication at bedtime and requesting that the
0
physician order it
4. Moving the patient further away from the nurse's station to minimize disturbances
te rs
A 68-year-old man calls his daughter every night to talk about his beloved wife who died
s
four weeks ago. During the day, he is sad and goes out frequently to get away from the
empty house. The man's most probable state is:
a
1. depression.
2. mourning.
m
3. neurosis.
i z
4. prolonged grief.
q u
The main reason that older adults with a chronic illness tolerate functional impairments
is that they:
1. are afraid to seek medical advice for fear of what they may find.
2. associate their symptoms with aging rather than an illness.
3. believe in home remedies and parental traditions.
4. relate their symptoms to conditions that resolved in the past without treatment.
An 87-year-old man, who has been living independently, is entering a nursing home. To
help him adjust, the most effective action is to:
1. involve him in as many activities as possible so he can meet other residents.
2. move him as quickly as possible so that he does not have time to think.
3. restrict family visits for the first two weeks to give him time to adjust.
4. suggest that he bring his favorite things from home to make his room seem
familiar.
all the be
,An 80-year-old patient is in the terminal stage of Alzheimer disease. The treatment team
meets with the patient's who are angry and complain about a recent incident in which
their parent's dentures were misplaced. The team members realize that:
1. anger at staff is a symptom of grief and needs to be addressed.
2. anxiety about the meeting may have interfered with the children's affect.
3. material items are the focus for the children at this time.
4. the focus of control should shift to the parent.
When relocating from a family home to a continuing care community, the most crucial
factor in an older person's adjustment is his or her:
1
1. level of economic independence.
0
2. perceived control of the move.
3. physical proximity to remaining family.
rs
4. risk-taking ability.
s te
A 78-year-old male resident at a long-term care facility, who is a former business
executive, has been smoking and extinguishing cigarettes in a paper cup in areas
a
where smoking is prohibited. He has been informed repeatedly of the designated
smoking areas. The resident's behavior indicates an attempt to:
m
1. express self-transcendence.
i z
2. maintain autonomy by exercising control.
3. maintain his previous professional role.
u
4. react against the facility's ageism.
q
A gerontological nurse is caring for an older adult who has been confined to home for
the last 10 weeks due to illness. The patient is anxious, has multiple somatic
complaints, and has become unable to follow instructions. The nurse knows that this
phenomenon commonly occurs with:
1. environmental overload.
2. protective isolation.
3. selective inattention.
4. sensory deprivation.
all the be
, The gerontological nurse facilitates the benefits of life review by:
1. assisting the older adult to accept death as the inevitable last stage.
2. changing the topic when a patient talks about his or her morbid past.
3. encouraging reminiscence, oral histories, and storytelling.
4. helping the older adult explore how spiritual involvement assists with stress relief.
The holiday season is approaching and a woman is admitted to a psychiatric unit. She
reports that her husband of 45 years passed away four weeks ago. She frequently cries,
eats poorly, periodically complains of back and stomach aches, and has begun isolating
herself. What type of grief is this woman exhibiting?
1
1. Acute
0
2. Anticipatory
3. Disenfranchising
rs
4. Dysfunctional
s te
A 92-year old patient, who recently underwent a below-the-knee leg amputation, is
resisting attempts at rehabilitation. The most likely reason for the resistance is that the
a
patient:
1. has goals that differ from the rehabilitation care plan.
m
2. has too many disabilities to realistically plan for rehabilitation.
i z
3. is too old to undergo rehabilitation.
4. requires a psychiatrist's assistance to deal with the loss.
q u
When the gerontological nurse in a clinic asks a 70-year-old man about his sexual
activity, he begins to cry and says, "I feel so bad for my wife; she is only 60, and I can't
seem to satisfy her as often as I used to." Which is the nurse's most appropriate
response?
1. "At your age, sexual activity diminishes because of changes in your circulation. I
will explain this to your wife."
2. "Certain body functions, such as erections, slow down with age. Could you tell
me more about your sexual relations? For instance, how often do you have
intercourse?"
3. "Your problem is probably an emotional one. If you could relax, you would be as
sexually active as you were 10 years ago."
4. "Your problem is probably due to a decrease in your sexual hormones. This
occurs naturally as people age."
all the be
Exam Study Guide
1
Which assessment tool measures economic resources, mental health, and activities of
0
daily living?
rs
1. Lawton's Physical Self-Maintenance Scale
2. Older Americans Resources and Services Assessment
e
3. Problem Oriented Medical Record
t
4. Short Portable Mental Status Questionnaire
as
All care plans for older adult patients include:
m
1. a bowel and bladder program.
z
2. a fall prevention program.
i
3. discharge planning.
u
4. reminiscence therapy.
q
An older adult patient, who is recovering from surgery, has a sodium level of 128 mEq/L
and is confused. The physician diagnoses syndrome of inappropriate secretion of
antidiuretic hormone. The gerontological nurse's primary goal for this patient is to:
1. decrease edema by restricting free water intake.
2. prevent complications of hyponatremia.
3. reorient the patient to his or her surroundings.
4. restore the patient's fluid and electrolyte balance.
The adult children of an aging couple ask a gerontological nurse about alternative
therapies or nontraditional services to improve their parents' health. The nurse's most
appropriate response is to:
1. discuss the benefits, risks, and limitations of various therapies.
2. distinguish between folk and traditional medicine.
all the be
,3. give a firm warning about alternative therapies.
4. recommend a reputable holistic health therapist.
A 73-year-old patient is admitted to a rehabilitation facility after sustaining a mild stroke.
After three nights in the facility, the patient begins to sleep only four to five hours a night
and to awaken frequently during the night. The patient then complains of not feeling
rested and begins to nap during the day. Which is the most appropriate nursing action?
1. Completing an assessment of the patient's sleep-wake cycle to determine
necessary interventions
2. Doing nothing since this type of sleep pattern is associated with normal aging
1
3. Inquiring if the patient takes a medication at bedtime and requesting that the
0
physician order it
4. Moving the patient further away from the nurse's station to minimize disturbances
te rs
A 68-year-old man calls his daughter every night to talk about his beloved wife who died
s
four weeks ago. During the day, he is sad and goes out frequently to get away from the
empty house. The man's most probable state is:
a
1. depression.
2. mourning.
m
3. neurosis.
i z
4. prolonged grief.
q u
The main reason that older adults with a chronic illness tolerate functional impairments
is that they:
1. are afraid to seek medical advice for fear of what they may find.
2. associate their symptoms with aging rather than an illness.
3. believe in home remedies and parental traditions.
4. relate their symptoms to conditions that resolved in the past without treatment.
An 87-year-old man, who has been living independently, is entering a nursing home. To
help him adjust, the most effective action is to:
1. involve him in as many activities as possible so he can meet other residents.
2. move him as quickly as possible so that he does not have time to think.
3. restrict family visits for the first two weeks to give him time to adjust.
4. suggest that he bring his favorite things from home to make his room seem
familiar.
all the be
,An 80-year-old patient is in the terminal stage of Alzheimer disease. The treatment team
meets with the patient's who are angry and complain about a recent incident in which
their parent's dentures were misplaced. The team members realize that:
1. anger at staff is a symptom of grief and needs to be addressed.
2. anxiety about the meeting may have interfered with the children's affect.
3. material items are the focus for the children at this time.
4. the focus of control should shift to the parent.
When relocating from a family home to a continuing care community, the most crucial
factor in an older person's adjustment is his or her:
1
1. level of economic independence.
0
2. perceived control of the move.
3. physical proximity to remaining family.
rs
4. risk-taking ability.
s te
A 78-year-old male resident at a long-term care facility, who is a former business
executive, has been smoking and extinguishing cigarettes in a paper cup in areas
a
where smoking is prohibited. He has been informed repeatedly of the designated
smoking areas. The resident's behavior indicates an attempt to:
m
1. express self-transcendence.
i z
2. maintain autonomy by exercising control.
3. maintain his previous professional role.
u
4. react against the facility's ageism.
q
A gerontological nurse is caring for an older adult who has been confined to home for
the last 10 weeks due to illness. The patient is anxious, has multiple somatic
complaints, and has become unable to follow instructions. The nurse knows that this
phenomenon commonly occurs with:
1. environmental overload.
2. protective isolation.
3. selective inattention.
4. sensory deprivation.
all the be
, The gerontological nurse facilitates the benefits of life review by:
1. assisting the older adult to accept death as the inevitable last stage.
2. changing the topic when a patient talks about his or her morbid past.
3. encouraging reminiscence, oral histories, and storytelling.
4. helping the older adult explore how spiritual involvement assists with stress relief.
The holiday season is approaching and a woman is admitted to a psychiatric unit. She
reports that her husband of 45 years passed away four weeks ago. She frequently cries,
eats poorly, periodically complains of back and stomach aches, and has begun isolating
herself. What type of grief is this woman exhibiting?
1
1. Acute
0
2. Anticipatory
3. Disenfranchising
rs
4. Dysfunctional
s te
A 92-year old patient, who recently underwent a below-the-knee leg amputation, is
resisting attempts at rehabilitation. The most likely reason for the resistance is that the
a
patient:
1. has goals that differ from the rehabilitation care plan.
m
2. has too many disabilities to realistically plan for rehabilitation.
i z
3. is too old to undergo rehabilitation.
4. requires a psychiatrist's assistance to deal with the loss.
q u
When the gerontological nurse in a clinic asks a 70-year-old man about his sexual
activity, he begins to cry and says, "I feel so bad for my wife; she is only 60, and I can't
seem to satisfy her as often as I used to." Which is the nurse's most appropriate
response?
1. "At your age, sexual activity diminishes because of changes in your circulation. I
will explain this to your wife."
2. "Certain body functions, such as erections, slow down with age. Could you tell
me more about your sexual relations? For instance, how often do you have
intercourse?"
3. "Your problem is probably an emotional one. If you could relax, you would be as
sexually active as you were 10 years ago."
4. "Your problem is probably due to a decrease in your sexual hormones. This
occurs naturally as people age."
all the be
